Spinal implant for motion preservation or fusion

An interspinous posterior device comprising:

• a body with a longitudinal anterior-posterior axis with a closed anterior end and an open posterior end and a superior arm and an inferior arm and a space in between the superior arm and the inferior arm, wherein the posterior and inferior arms are able to bend toward each other or away from each other;
• a pair of opposing barrels extending from the superior arm, each of said barrels comprising one or more rows of ratchet slots or ratchet teeth;
• a pair of opposing barrels extending from the inferior arm, each of said barrels comprising one or more rows of ratchet slots or ratchet teeth;
• and
• four cylinders, each cylinder sized to fit within one of the barrels, each of said cylinders comprising one or more rows of ratchet teeth that mates with the one or more rows of ratchet slots or ratchet teeth of the barrels.

A method of performing an orthopedic surgical procedure comprising the steps of:

• implanting an interspinous posterior device (IPD) in between two successive interspinous processes of a mammalian subject, wherein the IPD comprises:
• a body;
• and
• bone fixation elements on either side of the body, each of said bone fixation elements comprising a ratchet locking mechanism for fixing the body to successive spinous processes of a mammalian body;
• wherein the body has a dynamic configuration and a non-dynamic configuration;
• determining whether the IPD is to be dynamic allowing for extension of the successive spinous processes or non-dynamic prohibiting extension of the successive spinous processes;
• and
• if the IPD is to be non-dynamic, inserting an extension restriction block into the body to prohibit extension of the successive spinous processes.